NCD20.11

 

INTRAOPERATIVE VENTRICULAR MAPPING

 

Effective Date of this Version

10/29/1984

 

Benefit Category

• Inpatient Hospital Services

• Physicians' Services

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Item/Service Description

• Intraoperative ventricular mapping is the technique of recording cardiac electrical activity directly from the heart.

• The recording sites are usually identified from an anatomical grid and may consist of epicardial, intramural, and endocardial sites.

• A probe with electrodes is used to explore these surfaces and generate a map that displays the sequence of electrical activation.

• This information is used by the surgeon to locate precisely the site of an operative intervention.

 

Indications and Limitations of Coverage

• The intraoperative ventricular mapping procedure is covered under Medicare only for the uses and medical conditions described below:

o Localize accessory pathways associated with the Wolff-Parkinson-White (WPW) and other preexcitation syndromes.

o Map the sequence of atrial and ventricular activation for drug-resistant supraventricular tachycardias.

o Delineate the anatomical course of His bundle and/or bundle branches during corrective cardiac surgery for congenital heart diseases.

o Direct the surgical treatment of patients with refractory ventricular tachyarrhythmias.

 

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